When Did Health Become Thinking Out Of The Box?
Sunday, February 25, 2007
Jolie Bookspan, M.Ed, PhD, FAWM
We're just back from teaching the medical school elective in wilderness medicine. Each year I teach there, working over my birthday. Same food as last year. But the creek was thinly iced - good for ice swimming.
Before lecturing, I worried that my information on health - stand up straight, eat right, exercise, "and all that," would be so known and obvious to the bright young medical students that it would bore them. Instead, it was called, "Out of the box." When did health become out of the box?
I spent years of my career in a lab as a serious, intensely number-checking research scientist. I worked to ensure that we knew what truly worked, and what was hype, unrelated, or just wrong. I made certain that what I discovered and developed for patients was squarely right, practical, and in the best interest of the patient (and fun too, which is health). All I pursued was The Truth. Matt Cartmill once said, "As a youth I craved factual certainty, and I thirsted for a meaningful vision of human life. So I became a scientist. This is like becoming an archbishop so you can meet women."
Why is bypass surgery, angioplasty, stents, obesity, diabetes, and medications with uncomfortable, unhealthful side effects considered normal, while eating a vegetarian diet is labeled wacky and extreme when it is medically documented to stop and prevent heart disease, diabetes, high blood pressure, and other prevalent conditions that rob people of joy in life?
In my diving medicine lectures, I wanted students to see how the information worked and how it relates to many things in and out of diving, not just dictate lists of conditions to memorize. I showed slides, asking them to identify why an accident would happen on the way down versus up and why. I told them that if they understood, they would not have to memorize. I just wanted them to think. As my father once enlightened me, "Jolie, you're asking a lot!"
In the orthopedic lectures, I taught the same principles I tell in this Fitness Fixer blog of gaining great physical improvements without making pain and injury in the first place. After one of my lectures, students scattered for personal time, while a few stayed in the lecture hall, bent over laptops. They sat hunched, rubbing sore shoulders. Eventually one nudged the other, "Get the doc, she's right here." After some indecision, one student asked me to give him stretches to fix the pain of working at the computer. I told him you can sit and work without getting pain in the first place, and why didn't I show him that, instead of a stretch as an "antidote." He protested that the computer made his neck hurt. I agreed that the way he was sitting would do that, and repeated that you can easily sit and work in a way that doesn't cause the pain in the first place. More protests came, that as students they had to work on the computer long hours.
Medicine is not supposed to consist of allowing bad things to happen so that you can do a cool procedure to try to reverse it. Readers, do you want to try what I showed him and get a free house-call right now?
- I moved his chair in close to the table where he was working. Move yours in close now.
- Standing behind him with my hands on his shoulders, I gently pulled his upper body up and back to rest against the chair back. At home you can feel me guide your shoulders and upper body back.
- Next, keep the chin gently in, not jutting forward.
- We moved his computer back from the front edge of the table to make room to rest his forearms while using the keyboard. If you use a "below-desk" keyboard tray, it is often better to move the keyboard back to the desk. Don't crane your wrists, making a new problem. Relax and breathe.
- I told them that at my own desks, I raise computer on a shelf, block, or book about 10 inches higher than desk level, and use a cheap external keyboard. Even without these helpful changes, you don't have to round forward over a laptop.
- The seat back of the lecture chairs were concave - shaped to curve like the letter "C" so that you sat rounded forward. This is a common problem in many chairs, even some called ergonomic chairs. Another of the students mentioned he had a commercial lumbar roll at home. It was expensive and he didn't use it much because it was uncomfortable. I showed them how to use a small soft roll, which can be your gloves or light sweater, nothing fancy or expensive. Nestle it in the small inward curve of the lower back, then press your upper back, not lower back, against the chair back so that you can sit straight and lean back, instead of rounding forward. Pressing the lower back against the lumbar roll is a common way to make it useless and uncomfortable.
It turned out that most of the young, active, outdoorsy, academically talented medical students had muscle and joint pain. So did many of the top ranked physician faculty. Several told me they thought their pain was normal from their activities, from studying, their fallen arches, or body structure. They regularly took anti-inflammatory medicines and thought they needed special shoes.
You probably heard not to slouch since you were a child. That easy medicine hasn't changed. You heard to eat vegetables for health and an apple a day to keep the doctor away. I think only a few of the medical students I was teaching caught on, and will help others with what they learned. It can be so easy. As for the rest? Who is the one who is out of the box?
Are you doing unhealthy sitting without realizing it, during work, play, and exercise?:
Are You Making Your Exercise Unhealthy?
Disc Pain - Not a Mystery, Easy to Fix
Sitting Badly Isn't Magically Healthy by Calling It a Hamstring Stretch.
How to use your own muscles for healthy foot and ankle mechanics to prevent pain:
It's not the backpacks, but mostly how you carry them that makes or stops back pain:
- Healthier Backpack Carrying to Get Better Exercise and Stop Back Pain
- Carrying Schoolbooks Is Not the Cause of Back Pain
All-in-one resources for healthier pain free life:
- Fix Your Own Pain Without Drugs or Surgery. Chapters on fixing each kind of pain plus patient stories in every chapter tell how things work, why, and why not.
- Health & Fitness THIRD ed - How to Be Healthy Happy and Fit For The Rest of Your Life. Exercise, food, health, fixing pain, functional built-in healthy life, family, mental, it's all here.
- Healthy Martial Arts. Top level book for any athlete or those who would like to be.
- Click the link www.DrBookspan.com/books.
---
Questions come in by hundreds. I make posts from fun mail. Before asking more, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Why not try fun stuff, then contribute! Read success stories of these methods and send your own.
Subscribe to The Fitness Fixer, free. Click "updates via e-mail" (under trumpet) upper right.
See Dr. Bookspan's Books, take a Class, get certified - DrBookspan.com/Academy.
---
Labels: arches, blood pressure, drugs, education, fix pain, nutrition, practice of medicine, sitting, upper back
6 Comments:
At Monday, February 26, 2007 7:57:00 AM,
Rhiannon Miller said…
Out of interest, what do you think of the suggestion on this site? I've found it very helpful, although I need to sit at the very front of the chair and thus can't use the chair back to guide my shoulders back. Sitting at the front of the chair also helps with 'bucket' chairs of the sort you describe.
These days I'm finding that my biggest problem is actually while sleeping. I tend to sleep on my side and find that my shoulders round forward and hunch up while I'm asleep, so I wake in the morning stiff and sore. I don't sleep very well on my back. Any suggestions?
At Wednesday, February 28, 2007 11:16:00 PM,
Margaret Polaneczky, MD (aka TBTAM) said…
This is a great post.
You might be interested in looking at Alexander technique. I did this training alittle while back, adn it was termendously helpful in helping me see that much of my discomfort cam from how I was using my body on a day to day basis.
At Thursday, March 01, 2007 4:11:00 PM,
Jolie Bookspan, M.Ed, PhD, FAWM said…
Rhiannon, thank you (I think) for sending the link. The "Sitting" article you kindly supplied contains so many fallacies that I have been writing your reply for the last three days. The list of corrections grew longer than the article.
I think I can summarize by referring to figure 2 where he states that sitting upright "is impossible" to be maintained for more than one or two minutes, then claims that you cannot move your spine or hip more than a narrow range degrees when sitting, with supposed "validation" from an incorrect Figure 3 diagram. He is not correct unless you have tetanus. You can easily more your spine and hip more than that to prevent all the problems he claims. He goes on with more figures showing exact seating angles that need to be maintained. This is missing the whole point.
You are the one to control your hip and spine joint angles. You can sit in terrible position in the best chair, a tilted seat, or on the edge of a chair. You can overly arch backward or overly round forward. It is not fixed by anatomy or the chair. The exact angles that he claims are not correct, or even necessary.
Next, don't worry that you must sit on the edge of your chair. That is used in torture interrogation. Lean back and relax, using the general principles I give so that you can work hours at a desk (I sure do) without pain, sit at the theater, and for long flights and travel.
The post Don't Fall for Don't Sit Up Straight tells a little more about comfortably getting the purpose of a movement, not rigidly adhering to false rules, missing the whole point of health.
For pain after side sleeping, is your bed hard? That is a common cause. A five-dollar foam mattress pad can help. It is a common fallacy that you need a hard bed for back health. Expensive "posture" mattresses are a common cause of back pain.
At Thursday, March 01, 2007 4:18:00 PM,
Jolie Bookspan, M.Ed, PhD, FAWM said…
Hi Rhiannon again, good questions.
Not being comfortable when lying on your back sometimes indicates a tight front hip. When the front muscles are tight, it keeps your hip bent slightly at the crease of the leg. Trying to straighten the legs to lie flat (on your front or back) pulls the lower back up into an arch, pinching it. This is often perpetuated by the unfortunate fallacy that you must keep knees bent when lying on the back. That only keeps the hip tight. If you must keep knees bent when exercising on the back, as claimed by exercise teachers, how are you supposed to get up and walk away? Bent legged? If you can't lie straight, you can't stand straight. No wonder things hurt.
I cover hip stretches in
Instantly Better Hip and Quadriceps Stretch
and show how to watch for hip tightness in Is Bad Martial Arts Good Exercise?
At Thursday, March 01, 2007 5:11:00 PM,
Jolie Bookspan, M.Ed, PhD, FAWM said…
Hi Dr. T, thank you. Nice photos of New York on your blog.
I see many Alexander Technique instructors as patients for back, neck and other musculoskeletal pain.
It's good that you got the purpose of the instruction- to notice and stop what is wrong. Many people miss that and only follow the instructions - to be comfortable. They slump and slouch comfortably into positions dictated by their tightness, perpetuating the problem, comfortable until it grinds away, showing up far later as injury.
A few posts show more about why, starting with the first Fitness Fixer post,
Welcome to the Fitness Fixer
and continuing with
Conference on Aging Dec 2, 2006 in Midtown New York
and today's post
Why So Many Aerobics Injuries?
Maybe you'd like to come down for a fun class here sometime. With your knowledge, you'd be great and can pass it on to your own patients. This Saturday I'm teaching Fix Your Own Back and Neck Pain in downtown Philadelphia. Info on the post
New Year's Resolutions. Everyone welcome.
At Sunday, March 11, 2007 4:48:00 PM,
Jolie Bookspan, M.Ed, PhD, FAWM said…
Rhiannon, regarding your first question, you do not need a chair back to "guide your shoulders back." Just as you do not need one when standing. Just easily and comfortably pull them away from rounding forward.
Post a Comment
<< Home